[Public Papers of the Presidents of the United States: William J. Clinton (1994, Book I)]
[July 23, 1994]
[Pages 1302-1303]
[From the U.S. Government Publishing Office www.gpo.gov]



The President's Radio Address
July 23, 1994

    Good morning. Ever since Franklin Roosevelt, seven Presidents of 
both parties have worked to reform our Nation's health care system to 
provide health coverage to all Americans. That's always been the goal, 
to make sure that hard-working middle class families had the medical and 
the economic security they need to build good lives for themselves and 
their children.
    Now, for the first time in more than a decade, the American people 
are again insisting that we reform health care to contain costs and 
provide coverage for everybody. With your votes across the country in 
the last couple of years, you've told Washington in clear terms that you 
want guaranteed health security. And as your President that's exactly 
what I've been fighting for.
    It's more urgent today than it has been in years, not only because 
America pays far more of our income for health care than anybody else 
but because we're going in the wrong direction. Ten years ago, about 88 
percent of our people had health insurance coverage. Today, it's below 
83 percent and dropping. In just the last 5 years, 5 million Americans 
have lost their health insurance. But my clear and unchanged goal is 
universal coverage that will protect hard-working Americans.
    We've already come a long way in this debate. Both Houses of 
Congress will soon begin their historic floor debates because, for the 
first time in American history, committees of Congress have actually 
voted out bills that will guarantee coverage to all Americans.
    Yet many interest groups are still fighting against it. Already, 
over $100 million has been spent by interests trying to persuade you to 
back away from real reform, trying to persuade you that it can't work. 
Fortunately, I think most people see through these ad campaigns. Eight 
in ten Americans insist they still want universal coverage. And 
fortunately we've got an example of where it works in the State of 
Hawaii, where employers and employees share responsibility and all are 
required to purchase insurance. There is coverage for all workers and 
their families, and small business insurance rates are 30 percent below 
the national average. That's right, in a State like Hawaii where 
everything else is more expensive than the rest of the country, health 
insurance is cheaper, because everybody does their part and everybody's 
covered.
    Still, at this moment of decision, you're going to be bombarded with 
a last-ditch special interest media blizzard aimed at derailing reform 
and frightening you. That's why it's so important right now that you 
keep your focus on what matters most: How are we going to guarantee 
health security for all Americans? And don't let anybody convince you it 
can't be done. Every other advanced country has done it. And in our own 
country, one State's been doing it for 20 years now.
    One of the things a lot of people will say to you is that we ought 
to have some modified half measures to make things a little better. 
Unfortunately, a lot of these half measures may not work.
    Let's just take the case for insurance reforms. Here's why it won't 
work. One of the proposed insurance reforms that all of us would agree 
with is that people ought to be able to buy insurance, even if someone 
in their family has

[[Page 1303]]

been sick and has a so-called preexisting condition. And if they change 
jobs, they ought to be able to carry the insurance with them and not 
lose it.
    Here's why just doing that is not enough. If you don't require 
everybody to have insurance, if you don't require universal coverage, 
that means low-risk individuals, younger people, single people, aren't 
necessarily included in these insurance pools, which means that the pool 
has relatively more sick people. Higher risk insurance pools means that 
premiums go up for those that are currently insured. What happens then? 
That means some more healthy individuals drop out because they don't 
think they'll get sick, and small businesses that are on the margin of 
profitability, well, they also often drop out. That means the pool is 
even smaller, which means the risk is even higher, which means the rates 
get raised again, which means even more younger healthy people drop out 
and more small businesses drop out. It's a vicious cycle.
    To make matters even more complicated and tougher, when the 
uninsured low-risk people do get sick or have accidents, they still get 
health care, but it's too late, too expensive at the emergency room, and 
very often they can't afford to pay for it themselves. So their costs 
get passed on from medical providers back through the insurance system, 
back onto the Americans who are still paying insurance. And the premiums 
rise again. And again, it becomes harder for working people to afford 
insurance.
    A recent study by the Catholic Health Association demonstrates how 
all these forces work together to hurt the middle class. Every year, 
according to the Catholic Health Association, these limited reforms 
would pick $27 billion from the pockets of working Americans and their 
families who do pay for insurance, $800 apiece for families earning 
between $30,000 and $40,000 a year. Can you imagine the outcry if 
Congress tried to impose a direct tax of that kind on working families? 
But that's exactly what these nonuniversal plans will wind up doing.
    Right now we're hearing from the same kind of critics we hear from 
every time this country fights to help middle class families with 
efforts like Social Security and Medicare. They say small business will 
be hurt by this. They say it's too bureaucratic, that it's too costly, 
that Americans will lose their choice.
    But the truth is, this is not a Government plan, it's private 
insurance for all Americans. We phase it in on a period of several 
years, there's less regulation than when it was originally proposed, 
choice is protected, and we contain costs.
    And remember, most small businesses do insure their employees, and 
they pay 30 to 40 percent more for it than they would if they were 
buying in big pools like Government or big business. Only Hawaii has 
required all small businesses to participate, and their rates are lower.
    These are the kinds of objections that we've heard every time we've 
tried to do something like Social Security or Medicare. President 
Johnson heard these objections during the Medicare debate until the very 
end of the vote. But 29 years ago next week, he was able to sign 
legislation creating a system that has helped hundreds of millions of 
older Americans and their families. The American people made it clear 
then that they wanted reform. And today, the pen President Johnson used 
to sign that legislation is mounted in a position of honor in the White 
House, just down the hall from where I'm speaking. And if you tried to 
repeal Medicare, Members of Congress from both parties would never let 
it happen.
    Your concerns and your voices have carried us this far in this 
historic debate. Now we have to keep our focus for a few more weeks so 
we can win a battle that has been fought for 60 years. Together, America 
can join the ranks of other countries. America can do what we have 
needed to do a long time, create a health care system that guarantees 
health insurance for all Americans. And in doing that, we can make sure 
our middle class has a chance to keep growing for another generation of 
American children.
    Thanks for listening.

Note: The address was recorded at 12:10 p.m. on July 22 in the Roosevelt 
Room at the White House for broadcast at 10:06 a.m. on July 23.